Paragon Health Institute Icon White

Paragon’s Newest WSJ Op-ed Sets the Record Straight on Medicaid Redeterminations

President at Paragon Health Institute
Brian Blase, Ph.D., is the President of Paragon Health Institute. Brian was Special Assistant to the President for Economic Policy at the White House’s National Economic Council (NEC) from 2017-2019, where he coordinated the development and execution of numerous health policies and advised the President, NEC director, and senior officials. After leaving the White House, Brian founded Blase Policy Strategies and serves as its CEO.

The Wall Street Journal published a new piece from me related to Medicaid redeterminations. This piece follows two recent Paragon reports: The Cost of Good Intentions: The Harm of Delaying the Disenrollment of Medicaid Ineligibles and Pandemic Unwinding: How States Should Clean Up Their Medicaid Rolls.
As of April 1, there were roughly 18 million Medicaid enrollees who were not eligible for the program. Most ineligible enrollees have workplace coverage, make too much money to qualify for the program, have moved states, or have died.
The op-ed, which the Journal titled, “Got Insurance: You May be on Medicaid Too,” begins with a quantification of the monthly expense of keeping ineligible enrollees on the program and explains why so much of the concern being raised about redeterminations is unwarranted.

American taxpayers have been sending more than $6 billion a month to insurance companies for services provided under Medicaid to people who are ineligible—often because they’re enrolled in a private health plan. The Biden administration is pushing the boundaries of law and credulity by pressuring states to continue making these payments to insurers. …

As states begin eligibility redeterminations and removals of ineligible enrollees, left-leaning media is attempting to delegitimize these state efforts by claiming anyone who is disenrolled for failing to respond to a renewal application is having his coverage taken away for “procedural” reasons. This is misleading, even deceitful.

Someone who is ineligible because he has other coverage or income well above eligibility thresholds is unlikely to make the effort to return a renewal application. This includes roughly five million people now dually enrolled in an employer plan and Medicaid, as per the Congressional Budget Office. Most of the incentives in the system are biased toward continued enrollment, particularly those for insurers, which want to maintain enrollment to keep the checks from the government flowing.

No one wants eligible Medicaid enrollees to lose coverage. But if they do, they’re still effectively covered. Medicaid-eligible recipients can go to the hospital, enroll on site when they need services, and have the government pay expenses incurred, typically for the previous three months too. 

Paragon has estimated the individual costs of ineligible enrollees for each state as well as the potential cost savings from a more efficient redeterminations process. These costs mean fewer resources that states and the federal government can use for other purposes. As I concluded in the op-ed, “Removing people from welfare who aren’t eligible or who don’t provide evidence of eligibility after years without scrutiny is prudent governance. … The country can’t afford a permanent Medicaid Covid expansion, and the program is already too large to serve those who are eligible. It’s vital for the country that states return the program as quickly as possible to only those who are eligible.”
Read the full Wall Street Journal article here.

All the best,
Brian Blase
Paragon Health Institute

Recent Newsletters

New Paragon Study — Health Care Price Transparency: Achievements, Challenges, and Next Steps
An Offer That Can’t Be Refused


Sign up now for your health policy updates.

This field is for validation purposes and should be left unchanged.